SITREP 84


SITREP 84



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(ae World Health
S Organization
Ministry of Health and Social Services
Republic of Namibia
Outbreak Name | COVID-19 outbreak
Date & Time of | 10.06.2020
this report
22:30 hrs
Prepared by
Surveillance Team
Country affected ;
Investigation start
date
Namibia _
13 March 2020
SITUATION UPDATE / HIGHLIGHTS
No new confirmed case was recorded today (10 June 2020)
Cumulatively, 31 confirmed cases have been reported in the country.
Of the 31 confirmed cases, seventeen 17 (54.8%) have recovered.
Twenty-seven 27 (87.1%) of the confirmed cases are imported while 4 (12.9%) are
local transmissions.
No death has been recorded, case fatality rate is 0%
There is no evidence of community transmission in the country at the moment.
On 08 June 2020, His Excellency, The President of the Republic of Namibia
announced the extension of t the Stage | restrictions imposed on the Walvis Bay
Local Authority Area on 29 May 2020, is extended to the entire Erongo region;
o Effective from midnight 08 June 2020 until mignight 22 June 2020.
The other regions are still under Stage 3 of national lockdown which covers aperiod
of 28 days/ two incubation periods (01 June 2020 — 29 June 2020).

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2. BACKGROUND
Description of the cases
¢ Index cases: Two confirmed cases of COVID-19 were reported in Windhoek
district on 13 March 2020. The married couple; a 35-year-old male and a 25-year-
old female, arrived from Madrid, Spain on 11 March 2020.
0 The last confirmed cases were reported on 07 June 2020, a 27-years and 50
years old Namibian females who travelled from India via South Africa.
They arrived in the country on 24 May 2020 by road.
3. EPIDEMIOLOGY
Since 14 March, 2020 when the COVID-19 outbreak was declared in Namibia, a total of
31 cases have been confirmed. So far, four (4) regions have been affected, of which Khomas
region recorded the highest number of cases; 16 (51.6%), while Hardap region recorded
the least; 2 (6.5%), as per figure 1, below
18
16
14
‘3g5
12
10
Bs
3Es
’
Khomas
niah t
/]Karas
Erongo
Region
Be.
Hardap
™Number ofcases mActivecases mRecovered mDeath
Figure 1 Distribution of Confirmed COVID-19 cases in Namibia, by region as of 10 June
2020
As presented in figure 2 below, Namibia recorded its cases of COVID-19 during
epidemiological weeks 11, 12,13, 14,21, 22, 23 and 24 and most cases (7) were recorded during
epidemiological week 13.
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10 11 12 133014 «15 «16 17: 18 «19 20 21 22 23 24
Epidemiological week, 2020
Figure 2: Epi-curve for confirmed COVID-19 cases in Namibia as of 10 June 2020
Of the 31 confirmed cases, more males; 21 (67.7%) are infected compared to their female
counterparts; 10 (32.3%).
0
Oto9 10t019 20029 30039 40t049 S0toS9 G0t069 70to79 80+
Age group
mMale mFemale
Figure 3: Age and sex distribution of COVID-19 confirmed cases in Namibia as of 10 June
2020
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—1— 00 — 200 — 300 — 400 500 km
COVID-19 Cases-Namibia
© Positive Cases
Lab Tested Cases by District
(1 No Test
(2 <50
G@@B 5100-09-9399
@@ >2000
Figure 4: Distribution of suspected and confirmed COVID-19 cases in Namibia by District,
10 June 2020
4. PUBLIC HEALTH ACTION / RESPONSE INTERVENTIONS AND
SURVEILLANCE
Case definitions as of 20 March 2020:
Suspected case:
A. A patient with acute respiratory illness (fever and at least one sign/symptom of
respiratory disease, e.g., cough, shortness of breath), AND a history of travel to or
residence in a location reporting community transmission of COVID-19 disease
during the 14 days prior to symptom onset; OR
B. A patient with any acute respiratory illness AND having been in contact with a
confirmed or probable COVID-19 case in the last 14 days prior to symptom
onset; OR
C. A patient with severe acute respiratory illness (fever and at least one
sign/symptom of respiratory disease, e.g., cough, shortness of breath; AND

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requiring hospitalization) AND in the absence of an alternative diagnosis that fully
explains the clinical presentation.
Probable case: A suspect case for whom testing for COVID-19 is inconclusive.
Inconclusive being the result of the test reported by the laboratory
Confirmed case: A person with laboratory confirmation of COVID-19
irrespective of clinical signs and symptoms
infection,
e Active surveillance working case definition as of 20 April 2020
A patient diagnosed with Upper/Lower Respiratory Infection (Mild or Severe)
presenting any of the following signs and symptoms: cough, sore throat, fever,
chills, myalgia/body pains or shortness of breath in the past 7 days.
e Surveillance activities
© Call centre continue operations for 24 hours every day; 769 calls were answered
at the hotline today (10.06.2020) and 8 alerts were investigated.
e Namibia COVID-19 dashboard accessible via a link on the MoHSS’s website
http://www.mhss.gov.na/ or at https://cutt.ly/Covid-19-situation-Namibia
e Active case search in all regions is on going.
e Contact tracing and monitoring is ongoing (see Table 1).
e Mandatory supervised quarantine of all persons arriving from abroad is ongoing
(see Table 2).
o All people are tested upon entry into mandatory quarantine for rapid
detection of positive cases.
o All people in quarantine are monitored daily for 14 days and are being
tested on day 12 before release on day 15 if they test negative.
Contact tracing Summary
As of 10 June 2020, a total of 525 contacts have been identified. Four hundred and twenty-
three (427) contacts have completed their 14 days of follow up and 86 are still active and being
monitored daily for 14 days (Table 1).

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Table 1: National contacts tracing summary for COVID-19 as of 10 June 2020
Total Number of contacts listed for follow up (potential)
174
97
273 | 544
Total Number of contacts identified (cumulative)
174
97
254 | 525
Total number of Contacts never reached
1
0
33
34
Total Number of contacts lost to follow up
0
2
)
7
Total Number of contacts that developed signs & symptoms
25
9
9
43
Total Number of contacts that tested positive (became cases)
4
1
0
5
Number of active contacts monitored/followed in the last 24hrs | 30
15
41
86
Total number of Contacts completed 14-days follow up
140
81
206 | 427
As of 10 June 2020, a total of 2739 persons who came into the country have been placed into
supervised quarantine facilities around the country. Of the 2749, 1980 have been discharged
and 759 are currently quarantined (Table 2).
Table 2: Number of people in mandatory quarantine facilities as of 10 June 2020
Kunene
Omaheke
Kavango
Omusati
Oshana
Ohangwena
Hardap
Otjozondjupa
Khomas
Zambezi
//Karas
Erongo
Oshikoto
Total
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Table 3. Distribution of truck drivers who came into Namibia from neighboring countries
and their destination regions on 10 June 2020
Karas
Khomas
Oshana
Otjozondjupa
Kavango
Ohangwena
Hardap
Kunene
Omaheke
Omusati
Oshikoto
Zambezi
Erongo
Total
214
270
The majority 214 (79.3%) of the truck drivers departed from South Africa to various
destinations, of which the highest number (119) was headed to Khomas Region (Table 3).
LABORATORY INVESTIGATIONS
e Asof 10 June 2020, a total of 5315 (including 347 re-tested) COVID-19 specimens
have been tested in the two laboratories (NIP and Path Care) as per Table 5 below:
Table 5: COVID-19 specimens recorded at NIP and Path care Laboratories as of 10 June
2020
Total sample received by the Laborat
Total sample tested
Total sample re-tested
Total results positive
Total results negative
Total sample discarded
Total sample missin;
Total results pending
Total results inconclusive/indeterminate
Total new suspected cases in last 24 hours
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COUNTRY COORDINATION, PLANNING AND MONITORING
e Reviewed and incorporated inputs to the COVID-19 organogram from the deputy
incident manager, and agreed to submit these through the pillar lead to IM/Senior
executives for their final inputs and endorsement.
¢ UN Namibia donated assorted flow charts and posters on surveillance covering
contact tracing structure, contact identification and categorization, case definition,
laboratory results sharing structures.
CASE MANAGEMENT:
¢ Out of the 31 cumulative confirmed cases, 17 have recovered after testing negative
twice for COVID-19 at 48 hours’ interval.
¢ Ofthe 14 active cases, |is still in ICU but in a stable and improving condition. The
other 13 are clinically stable.
INFECTION PREVENTION AND CONTROL:
e IPC activities are on going:
© Distribution of PPE according to the Regional plans
o Monitoring of IPC in health facilities
¢ Three additional members have been seconded from CDC and Quality Assurance
to support the national IPC team.
e Continous monitoring of national IPC stock levels.
LOGISTICS.
¢ Facilitation of the allocation of quarantine facilities around the country and
transportation of discharged people from quarantine facilities is ongoing.
e PPE stock level
o Full PPE —2349
co Respirat—o6r08s7
o Medical masks— 1309
POINTS OF ENTRY:
e Ongoing screening and inspection of incoming travellers and trucks at points of
entry and check points.
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RISK COMMUNICATION AND COMMUNITY ENGAGEMENT:
e The COVID-19 Communication Center continues to update the public on the status
of the outbreak, the impact on different sectors and address rumours around
COVID-19.
PSYCHOSOCIAL SUPPORT SERVICES:
¢ Continous provision of health education, psychosocial support services to persons
in need;
o Confirmed cases and their families
© People in quarantine
5. CHALLENGES:
e Inadequate isolation units at health facilities in the regions.
e Insufficient PPE.
e Inadequate nasopharyngeal swabs and appropriate transport media.
6. RECOMMENDATIONS AND WAY FORWARD:
e Establish fully equipped isolation units at health facilities in the regions.
© Logistics pillar to continue with the procurement and distribution of sufficient PPE
to the regions to ensure that response is not interrupted.
© NIP to continue sourcing for swabs and appropriate transport media for all districts.
Approved:
Pr
Incident Manager
Date: 10 June 2020
Secretariat
For enquiries, please contact
Namibia Public Health Emergency Operations Centre;
Email: PHEOC@mhss.gov.na
Hotline Toll-free number: 0800 100 100
Hotline Whatsapp number: 085 1100 100
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